W 4V – Fill Out and Use This PDF

Form W-4V

Voluntary Withholding Request

(Rev. February 2018)

(For unemployment compensation and certain Federal Government and other payments.)

Department of the Treasury

▶ Go to WWW.IRS.GOV/FORMW4V for the latest information.

Internal Revenue Service

Instructions

Note. For withholding on social security benefits, give or send the

completed Form W-4V to your local Social Security Administration

Purpose of Form

office.

If you receive any government payment shown below, you may use

Line 3. If your address is outside the United States or the U.S.

Form W-4V to ask the payer to withhold federal income tax.

possessions, enter on line 3 the city, province or state, and name of the

• Unemployment compensation (including Railroad Unemployment

country. Follow the country’s practice for entering the postal code.

Don’t abbreviate the country name.

Insurance Act (RUIA) payments).

• Social security benefits.

Line 4. Enter the claim or identification number you use with your payer.

For withholding from social security benefits, the claim number is the

• Social security equivalent Tier 1 railroad retirement benefits.

social security number under which a claim is filed or benefits are paid

• Commodity Credit Corporation loans.

(for example, 123-45-6789A or 123-45-6789B6). The letter or

• Certain crop disaster payments under the Agricultural Act of 1949 or

letter/number combination suffix that follows the claim number identifies

the type of benefit (for example, a wage earner, a spouse, or a

under Title II of the Disaster Assistance Act of 1988.

widow(er)). The claim number may or may not be your own social

• Dividends and other distributions from Alaska Native Corporations

security number. If you are unsure about what number to use, contact

to its shareholders.

the Social Security Administration at 1-800-772-1213 (toll-free). For

Consult your payer if you’re uncertain whether your payment is

other government payments, consult your payer for the correct claim or

eligible for voluntary withholding.

identification number format.

You aren’t required to have federal income tax withheld from these

Line 5. If you want federal income tax withheld from your

payments. Your request is voluntary.

unemployment compensation, check the box on line 5. The payer will

Note. Payers may develop their own form for you to request federal

withhold 10% from each payment.

income tax withholding. If a payer gives you its own form instead of

Line 6. If you receive any of the payments listed on line 6, check the box

Form W-4V, use that form.

to indicate the percentage (7%, 10%, 12%, or 22%) you want withheld

Why Should I Request Withholding?

from each payment.

Line 7. See How Do I Stop Withholding? below.

You may find that having federal income tax withheld from the listed

Sign this form. Form W-4V is not considered valid unless you sign it.

payments is more convenient than making quarterly estimated tax

payments. However, if you have other income that isn’t subject to

When Will My Withholding Start?

withholding, consider making estimated tax payments. For more details,

Ask your payer exactly when income tax withholding will begin. The

see Form 1040-ES, Estimated Tax for Individuals.

federal income tax withholding you choose on this form will remain in

How Much Can I Have Withheld?

effect until you change or stop it or the payments stop.

For unemployment compensation, the payer is permitted to withhold

How Do I Change Withholding?

10% from each payment. No other percentage or amount is allowed.

If you are getting a payment other than unemployment compensation

For any other government payment listed above, you may choose to

and want to change your withholding rate, complete a new Form W-4V.

have the payer withhold federal income tax of 7%, 10%, 12%, or 22%

Give the new form to the payer.

from each payment, but no other percentage or amount.

How Do I Stop Withholding?

What Do I Need To Do?

If you want to stop withholding, complete a new Form W-4V. After

Complete lines 1 through 4; check one box on line 5, 6, or 7; sign Form

completing lines 1 through 4, check the box on line 7, and sign and date

W-4V; and give it to the payer, not to the IRS.

the form; then give the new form to the payer.

1

Your first name and middle initial

Last name

2 Your social security number

3

Home address (number and street or rural route)

City or town

State

ZIP code

Your signature ▶

Date ▶

For Privacy Act and Paperwork Reduction Act Notice, see page 2.

Cat. No. 22891V

Form W-4V (Rev. 2-2018)

Form W-4V (Rev. 2-2018)

Page 2